Individual provider Active NPI

Terricea Jean

  • Counselor
  • Germantown, MD
National Provider Identifier
1821648411
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
20410 Observation Dr Ste 108
Germantown, MD 20876-6419
Phone
(240) 296-5645
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

20410 Observation Dr Ste 108
Germantown, MD 20876-6419

Mailing address

20410 Observation Dr Ste 108
Germantown, MD 20876-6419

Other identifiers 1

IdentifierTypeStateIssuer
327612TD1MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL terricea@vesta.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104003766 MD Practitioner - Mental Health Counselor 1456841923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6470 Dobbin Rd
Suite C
Columbia, MD 21045-4767
Phone (855) 202-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Newpsych LC CurrentSince Aug 1, 2025 Accepting new patients

Locations

6470 Dobbin Rd
Ste C
Columbia, MD 21045
Phone (410) 900-9886

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1821648411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 OBSERVATION DR STE 108",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20410 OBSERVATION DR STE 108",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766419",
            "telephone_number": "240-296-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "TERRICEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327612TD1",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "terricea@vesta.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20410 Observation Dr Ste 108",
            "city": "Germantown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208766419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.